MEDICARE: CLYDE RUSSELL BOSWELL FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11012607	FL
2	363LF0000X	Family Nurse Practitioner	25373	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598229718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLYDE RUSSELL BOSWELL FNP-BC

Provider Business Mailing Address
First Line	:	1102 14TH ST N
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3662
Country	:	US
Telephone Number	:	615-830-6176
Fax Number	:

Provider Business Practice Location Address
First Line	:	8705 PERIMETER PARK BLVD STE 2
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6353
Country	:	US
Telephone Number	:	904-248-3910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2019
Last Update Date	:	03/16/2023

Similar Medicare Providers

1356310668 — DR. JAMES JOSEPH JOYCE M.D.
Practice Location Address:

8705 PERIMETER PARK BLVD STE 8
JACKSONVILLE, FL
32216-6353

Practice Phone: 904-296-7771
Practice Fax: 904-296-7772

1528267861 — DAVID HILL DO
Practice Location Address:

8705 PERIMETER PARK BLVD STE 2
JACKSONVILLE, FL
32216-6353

Practice Phone: 904-248-3910
Practice Fax: 904-248-3920

1801085725 — SHAW CHIROPRACTIC LLC
Practice Location Address:

8705 PERIMETER PARK BLVD STE 6
JACKSONVILLE, FL
32216-6353

Practice Phone: 904-997-1349
Practice Fax: 904-997-1369

1043675168 — DR. JOHN DARRELL ARCE DNP, FNP-C
Practice Location Address:

8705 PERIMETER PARK BLVD STE 2
JACKSONVILLE, FL
32216-6353

Practice Phone: 904-248-3910
Practice Fax:

1043726904 — KRISTINA AGRANAT ARNP-BC
Practice Location Address:

8705 PERIMETER PARK BLVD STE 2
JACKSONVILLE, FL
32216-6353

Practice Phone: 904-248-3910
Practice Fax:

1417521725 — BAPTIST SPECIALTY PHYSICIANS INC
Practice Location Address:

8705 PERIMETER PARK BLVD STE 8
JACKSONVILLE, FL
32216-6353

Practice Phone: 904-296-7771
Practice Fax: 904-296-7772

Directions to “ CLYDE RUSSELL BOSWELL FNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.